How Does Your Posture Affect Back Pain? How Do You Improve Posture?

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There are a number of problems that an individual can develop due to poor posture, especially while sitting. Lower back pain and hip immobility are a few of the lower extremity dysfunctions that are seen with this poor posture, while shoulder impingement and neck pain are seen in the upper regions of the body. Pain in the low back pain is one of the most prevalent causes of missed days at work for the working individual [1].

Lower back pain can be caused by lumbar disk prolapse and micro fractures, although the real reason is posed to question because of the general anatomy of the lumbar spine. The lumbar region is deep and hard to palpate/observe manually [1]. A majority of the symptoms for low back pain can be recreated by a combination of increased pressure due to bending and compression [1]. This is mostly due to the generation of increased stress on tissues and disks (intervertebral) within the lumbar spine [1].

This is the phenomenon seen in individuals who sit with an arched lower back due to poor posture while sitting. This arching of the lumbar spine causes mechanical loading of the spine and places unwanted pressure on the intervertebral disks of the lower back [1]. Bogduk and Twomey et al, looked at the nerve innervation within the lumbar spine as a proposed cause. These nerves supply the joints and surrounding musculature and when compressed or affected negatively, can cause very sharp/severe pain [1].

The vertebral body endplates also have sensory receptors and innervation that have a very high potential to cause significant pain when affected [1].

The Lumbar Spine

The lumbar spine can be affected in a couple ways. These ways include compression, bending, and then compression and bending (combo). For the sitting posture, the lumbar spine is most likely affected due to the bending the motion. The anterior bending of the lumbar spine is the direct opposite motion of the natural curvature of the spine. The spine naturally follows a lordodic curve up the torso.

With an anterior bend, the lumbar spine is resisted by the neural arch ligaments (supraspinous and interspinous) being the first ones to fail [1]. When excessive bending of the lumbar spine occurs, the joint capsule ligaments can rip and tear, or cause small fractures in the vertebral body. The individuals back muscles usually limit this excessive bending, but these muscles can become very weak and susceptible when the motion is repeated or prolonged for long periods of time [1]. Over this period of time, the lumbar spine will become weaker and weaker and eventually lead to increased pain and ultimately, injury.

Hip Mobility & Strength

Another dysfunction of poor sitting posture is decreased hip mobility and strength. When in a seated position for long periods of time, the hip joint can become dysfunctional and the muscles surrounding the joint can become short and underactive. When this is done for extensive periods of time, the dysfunction can be worsened. The SI joint contains muscles like the gluteus maximus, gluteus medius, piriformis, biceps femoris, tensor fascia late, etc.

The glutes are muscles that actually attach above the waist and right into the lower back, so when these muscles are weak and underactive, hip mobility can be lessened and lower back pain can be brought upon. This phenomenon is termed hip-spine syndrome [2]. This syndrome shows the influence of the hip joint pathology on the spinal alignment and associated muscle length and forces of the joints [2]. Ellison et al expressed this and compared hip rotation and range of motion with individuals with low back pain.

The individuals with lower back pain also possessed asymmetrical hip rotation range of motion [2]. Evidence suggests that impairments at the hip joint are related to lower back pain in individuals that show decreased strength and range of motion of the muscles of the hip joint [2]. A well-prescribed strength training regimen and flexibility protocol can build up the strength and mobility of these affected muscles and joints [2]. Getting up and moving around every so often is also helpful as to keep these muscles working and not letting them become underactive and weak.

Impingement

Rotator cuff impingement and neck impingement are also common problems associated with poor posture. This is seen in individuals who have a desk job or may look at a computer all day. This phenomenon is mostly caused by upper crossed syndrome in the upper body, seen through the individual possessing rounded shoulders. The shoulder joint will become compressed, more specifically the supraspinatus muscle of the rotator cuff [3].

Neck impingement can be caused by jutting the head forward to see the computer screen associated with poor vision. Jutting the head forward will place a lot of pressure on the scalenes, erector spinae, and associated muscles of the neck and upper back [3]. These impairments can be treated with chairs that promote better posture, core strength and having computer monitors at good lengths and heights to avoid neck straining. This is very important for individuals who work full-time jobs, as time away from the desk may be limited.

Getting up every so often will help reduce this risk for injury as well as prevent other dysfunctions from arising, such as low back pain and decreased hip mobility. Again, a good strength training and flexibility program can help these specific areas in increasing strength and range of motion.